Australia Urged To Improve “Moribund” HIV Response

23 July 2012

ACON claims Australia’s once world leading approach to HIV prevention is increasingly tired, static and falling behind international best practice.

The assessment is contained in a position statement released by ACON (formerly the AIDS Council of NSW) on the eve of the 2012 International AIDS Conference in Washington D.C.

The statement calls on the Australian Government to re-energise the domestic HIV prevention response following its commitment to the 2011 United Nations Political Declaration on HIV/AIDS which includes bold new prevention targets aimed at achieving significant reduction in HIV transmissions in Australia – and globally – by 2015.

Acting ACON CEO Geoff Honnor says ACON supports the view of Australia’s UN Ambassador Gary Quinlan who recently stated that Australia needs to do more to meet its UN commitment.

“We’ve had a contained epidemic in NSW for 15 years and in recent years national HIV diagnoses have also stabilised at around 1,000 new cases annually,” Mr Honnor says.

“We can be proud of what we’ve achieved historically but we need to dramatically increase the scope and momentum of our engagement to achieve the substantial decline in HIV transmission that’s required. What we’re doing is delivering stability, not decline. We need to add new prevention approaches to achieve a different outcome.

“However, the Australian Government so far appears reluctant to fast track the introduction of a range of new and emerging HIV prevention technologies which have already proven successful overseas.”

Mr Honnor says this includes rapid HIV testing. “Rapid HIV testing, which is available virtually everywhere else in the world, offers a quick, cheap and accessible means of dramatically improving access to testing,” Mr Honnor says.

“In 2011, a redraft of our National HIV Testing Policy finally supported introduction of rapid testing and a number of rapid testing trials are underway. However, 12 months later a rapid HIV test is yet to be licensed for use in Australia. Meanwhile the United States, European Union and New Zealand have all had rapid testing available for many years and the use of rapid testing in home-based settings was recently approved by the US Food and Drug Administration.

“The FDA also recently approved existing HIV treatment Truvada for use as pre-exposure prophylaxis or PrEP, which involves HIV negative people taking HIV medication to greatly reduce the risk of HIV transmission.

“In addition, the US made significant changes earlier in the year to its HIV treatment guidelines in recognition of recent research confirming that HIV therapy has a proven HIV transmission reduction benefit. The changes are designed to encourage more HIV positive people to seek access to the health - and prevention - benefits of treatment.

“Australia follows US treatment guidelines but a majority of the Australasian Society for HIV Medicine Panel – the role of which is to provide commentary on applying the guidelines in the Australian context – has declined to accept the updated US guidelines.

“Also, unlike the US FDA, Australia’s Therapeutic Goods Administration maintains a closed, non-consultative application process in relation to new HIV-related therapies and devices. It’s our understanding that there’s been one device under consideration now for almost a year.”

“None of this is to overlook the continuing contribution from HIV prescribers and HIV clinical, social, and behavioural research scientists and their world renowned institutions. Nor does it overlook the fact that committed individuals, and organisations – and in the case of NSW, government, bureaucracy and the HIV partnership more generally – remain dedicated to best outcome achievement.

“What’s lacking is the vision and determination to get Australia’s HIV response back to best practice, and it’s not so much about a massive increase in funding as it is about a massive increase in guts, will and imagination.

“What we have is a moribund response that’s mired in the past while the rest of the world, particularly the US, eagerly embraces what amounts to a revolution in HIV prevention that has the potential to bring the HIV epidemic to an end.

“Right now we have an unparalleled opportunity to achieve a dramatic reduction in HIV infections here in Australia, but in order to produce a dramatically different result we require radically different approaches.

“With the support of the NSW Government, ACON is well into the reinvention and reprioritising of our approach to HIV prevention.

“Against the odds, national peak HIV organisations such as the National Association of People Living With HIV/AIDS and the Australian Federation of AIDS Organisations are also engaged.

“This process of revitalisation should also be happening across the national response as a matter of priority and strong national leadership is crucial to achieving the renewal required.”

ACON acknowledges the traditional owners of the land we operate on across NSW and remind people that we are on Aboriginal land. ACON also acknowledges the Elders and in particular those visiting this website.